Individual provider Active NPI

Leonard John Litkowski, DDS

  • General Practice Dentistry
  • Rock Hall, MD
National Provider Identifier
1750651931
Registry record updated Jan 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9105 Issued in MD
Practice address
5775 S Main St
Rock Hall, MD 21661
Phone
(410) 778-1234
NPI assigned
Jan 5, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 9105 MD Primary

Addresses

Primary practice location

5775 S Main St
Rock Hall, MD 21661

Mailing address

5775 S Main St
Rock Hall, MD 21661
Phone (410) 778-1234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170105001199 MD Order and Referring Only - DentistPractitioner - Dentist 9032490099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9105MDMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1325721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325721600000",
    "number": "1750651931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5775 S MAIN ST",
            "city": "ROCK HALL",
            "state": "MD",
            "postal_code": "21661",
            "telephone_number": "410-778-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5775 S MAIN ST",
            "city": "ROCK HALL",
            "state": "MD",
            "postal_code": "21661",
            "telephone_number": "410-778-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITKOWSKI",
        "first_name": "LEONARD",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-05",
        "last_updated": "2012-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "9105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hall, MD

Sources for this page

Verify at the official NPI Registry.